立体定向适形放射治疗颅外中晚期恶性肿瘤近期疗效探讨

目的：为了探讨立体定向适形放射治疗（体部X-刀）对颅外中晚期恶性肿瘤的疗效及其与常规放疗联合应用的规律。方法：190例中晚期恶性肿瘤患者随机分成两组．进行前瞻性研究,联合组100例,常规放疗前程或后程实施立体定向适形放射治疗,另外90例给予常规放疗作为对照组．治疗后随访观察。结果：联合治疗组有效率达88％,对照组61％（P＜0．01）统计学差异显著。对照组并发症发生率9．4％．联合组11．0％（P＞0．05）统计学无显著差异。结论：颅外中晚期恶性肿瘤实施立体定向适形放射治疗可以明显提高疗效．治疗并发症未增加。     

三维适形放疗对ⅠA～ⅡA 期宫颈癌患者根治术后生存状况及疗效的影响

目的：研究三维适形放疗对ⅠA～ⅡA期宫颈癌患者根治术后的治疗效果及生存状况。方法选取进行治疗的64例ⅠA ～ⅡA 期宫颈癌患者作为研究对象,分为常规放疗组和三维适形放疗组,每组32例,宫颈癌术后分别采用常规放疗和三维适形放疗。观察比较两组患者的治疗效果和生存状况。结果与常规放疗（75．00％）相比,使用三维适形放射治疗后患者的治疗总有效率（96．87％）大大提高,其1、3、5年生存率也显著提高,早期放疗反应和晚期放疗反应均降低。以上指标两组比较差异均有统计学意义（P ＜0．05）。结论三维适形放疗对肿瘤细胞的杀灭更加全面、彻底,能够显著提高宫颈癌根治术后患者疗效,提高生存率,降低放疗反应。     

三维适形放射治疗配合替吉奥对直肠癌术后复发的作用研究

目的：探讨三维适形放射治疗配合替吉奥治疗术后复发直肠癌患者的效果。方法：将2011年1月至2013年1月收治的120例直肠癌术后复发的患者随机分作对照组80例与观察组80例。两组均给予三维适形放射治疗,观察组在此基础上给予替吉奥治疗,疗程结束后3个月CT复查,观察与比较两组临床疗效与不良反应。结果：观察组的总有效（83．33％）显著高于对照组（61．67％）,组间具统计学差异（χ2＝10．927,P＜0．05）。观察组疾病DCR为96．67％,对照组疾病DCR为83．33％,具统计学差异（χ2＝5．327,P＜0．05）;观察组与对照组1年、2年、3年生存率分别为96．67％、76．67％、38．33％与78．33％、51．67％、26．67％,观察组平均生存期为33个月,对照组平均生存期为27个月,组间生存期具统计学差异（ P＜0．05）;对照组与观察组白细胞减少的发生率分别为36．67％与25．0％,组间差异具统计学意义（P＜0．05）,其他不良反应的发生率未见统计学差异（P＞0．05）。结论：三维适形放射治疗配合替吉奥治疗术后直肠癌复发患者的效果确切,副反应轻,值得在临床予以推广。     

三维适形放疗联合培美曲塞治疗非鳞癌局部晚期肺癌的近期疗效及毒性反应

目的：观察三维适形放疗联合培美曲塞治疗非鳞癌局部晚期肺癌的近期疗效及毒性反应。方法：将2009年10月至2012年6月期间我院收治的非鳞癌局部晚期肺癌患者98例，将其随机分为观察组49例和对照组49例，观察组患者给予三维适形放疗联合培美曲塞进行治疗，对照组患者仅给予三维适形放疗，观察两组患者治疗的临床疗效及两组患者治疗后毒性反应的发生率。结果：两组患者经治疗后均取得一定的临床效果，观察组患者的有效率为63．3％明显高于对照组的32．7％，差异具有统计学意义（P＜0．05）；观察组患者毒性反应的发生率与对照组相比无显著差异（P＞0．05）。结论：三维适形放疗治疗非鳞癌局部晚期肺癌时应用培美曲塞能够显著提高患者的临床疗效，且用药后的毒性反应发生率没有增加，值得在临床普遍推广与应用。     

宫颈癌放疗患者的并发症护理及预防

目的：总结宫颈癌放射治疗患者的并发症预防及护理经验。方法：选的140例宫颈癌放射治疗患者,将其平分为观察组和对照组各70例,对照组采用常规护理,观察组在常规护理基础上给予综合护理,比较两组并发症的发生情况。结果：观察组并发症发生率为18．57％,明显低于对照组的64．29％。差异具有统计学意义（P＜0．05）。结论：宫颈癌放射治疗患者并发症的综合护理及预防,能有效减少并发症,减少患者痛苦,提高患者的生活质量。     

常规放疗与三维适形放疗治疗复发性宫颈癌的临床对比

目的观察三维适形放射治疗与常规体外放射治疗复发性宫颈癌的疗效及近远期并发症,以期寻找一种更有效的治疗复发性宫颈癌的方法。方法45例复发性宫颈癌分为常规放疗组(对照组)与三维适形放疗组(观察组)。治疗期间观察患者近期并发症;随访时观察近期疗效、1年生存率及远期并发症。结果治疗后疗效、1年生存率、近远期并发症比较,两组差异均有统计学意义(P<0.01)。结论三维适形放疗治疗复发性宫颈癌能提高近期疗效及1年生存率,降低近远期并发症的发生。     

三维适形放射治疗非小细胞肺癌的临床观察

目的：探讨三维适形放射治疗（3DCRT）非小细胞肺癌（NSCLC）的临床近期疗效和毒副反应。方法：对三维适形放疗的24例非小细胞肺癌患者（3DCRT组）临床资料进行分析，并与同期行常规放疗（RT）的18例非小细胞肺癌患者（对照组）的疗效和毒副反应进行对比。2组均每周照射5次，每次照射2Gy。结果：3DCRT组有效率（CR＋PR）为87．5％，常规放疗组为55．5％．两组差异无统计学意义（P〉0．05）。两组急性放射性食管炎发生率分别为33．3％和50％；放射性肺炎发生率分别为29．1％和44．4％；白细胞下降发生率分别37．5％和61．1％，两组差异均无统计学意义（P〉0．05）。结论：三维适形放射治疗NSCLC有较好的近期疗效．毒副反应较轻，远期疗效有待进一步观察。     

三维适形放射治疗与常规放射治疗不能手术宫颈癌的疗效观察

目的探讨三维适形放射治疗不能手术之宫颈癌患者的疗效。方法120例不能手术的宫颈癌患者随机分成治疗、对照组各60例。治疗组行三维适形放射治疗，总剂量70～76Gy；对照组采用体外照射加腔内照射，用8NV-X线前后对穿照射，全盆腔照射20Gy～30Gy后改为四野照射并同时行腔内照射，总剂量60～65Gy。结果治疗组与对照组总有效率分别为93．3％（56／60）和78．3％（47／60），5年总生存率分别为76．7％（46／60）和51．7％（31／60），阴道粘连狭窄发生率分别为11．7％（7／60）和30．0％（18／60），两组比较差异均有统计学意义。结论采用三维适形放射治疗不能手术的宫颈癌简单易行，治疗精确，局控率与生存率较常规放疗好，治疗反应轻，并发症降低，值得临床推广。     

三维适形放疗同期化疗治疗局部晚期鼻咽癌近期疗效观察

目的观察三维适形放疗同期化疗治疗局部晚期鼻咽癌的近期疗效。方法将我科2009年1月～2010年1月行三维适形放疗同期化疗的30例局部晚期鼻咽癌患者设立为观察组。另选择同期行常规放射治疗同期化疗治疗的30例局部晚期鼻咽癌患者设立为对照组,比较两组的临床疗效及并发症。结果观察组的有效率明显高于对照组,差异有统计学意义（P〈0．05）。结论三维适形放疗同期化疗治疗局部晚期鼻咽癌近期疗效优于常规放射治疗同期化疗治疗局部晚期鼻咽癌的疗效,副反应少,值得广泛推广和应用。     

经皮肺穿刺活检术患者实施护理干预的效果观察

目的：观察经皮肺穿刺活检术患者实施护理干预的效果。方法：随机选取2012年3月至2014年3月我院收治的98例肺内周围性占位性病变患者,依据随机数字表法将这些患者分为两组,即研究组和对照组,每组平均49例。给予对照组患者常规护理,给予研究组患者常规护理基础上的护理干预。结果：研究组患者的住院时间明显比对照组短（P＜0．05）,住院费用明显比对照组少（P＜0．05）,满意度明显比对照组高（P＜0．05）;研究组患者的并发症发生率18．4％（9／49）明显比对照组42．9％（21／49）低（P＜0．05）。结论：经皮肺穿刺活检术患者实施护理干预的效果显著,值得推广。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.